Prevalence of and detection of resistance to ampicillin and other beta-lactam antibiotics in Haemophilus influenzae in Denmark

Scand J Infect Dis. 2001;33(4):266-71. doi: 10.1080/003655401300077261.

Abstract

The susceptibility of Haemophilus influenzae to penicillin V and G, ampicillin and cefuroxime was investigated by MIC, disc and tablet diffusion methods, using chocolate agar as test medium, to determine the prevalence of ampicillin-resistant isolates and the optimal method for their detection. Eighty-six isolates were clinical isolates collected prospectively from July to September 1998 and 22 isolates were clinical isolates with decreased susceptibility to ampicillin previously referred to the reference laboratory. Eighty-seven isolates were ampicillin-susceptible and 16 were ampicillin-resistant. Thirteen produced beta-lactamases. Among the consecutive isolates 12.8% were resistant. With each of the Rosco Neo-sensitabs containing penicillin G, 2.5 microg ampicillin and 33 microg ampicillin, 3 very major errors occurred (resistant isolates misinterpreted as susceptible) and 5-13 major errors (susceptible isolates misinterpreted as resistant). The AB biodisk containing ampicillin (10 microg) was superior to the penicillin V and G discs, i.e. only 1 very major error occurred and major and minor errors were infrequent. The cefuroxime disc identified 4/8 beta-lactamase-negative ampicillin-resistant isolates. Thus, for susceptibility testing with chocolate agar as test medium, the use of an inoculum of 10(5) colony-forming units, 10 microg ampicillin discs and interpretative zone diameters of > or = 28 mm indicating susceptibility and < or = 25 mm indicating resistance was found to produce reliable identification of ampicillin-resistant isolates of H. influenzae.

Publication types

  • Comparative Study

MeSH terms

  • Ampicillin / pharmacology*
  • Anti-Bacterial Agents / pharmacology
  • Colony Count, Microbial
  • Culture Media
  • Denmark / epidemiology
  • Drug Resistance, Microbial
  • Haemophilus Infections / epidemiology
  • Haemophilus Infections / microbiology*
  • Haemophilus influenzae / classification
  • Haemophilus influenzae / drug effects*
  • Humans
  • Microbial Sensitivity Tests / standards
  • Penicillins / pharmacology*
  • Prospective Studies
  • Serotyping
  • beta-Lactam Resistance*
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • Culture Media
  • Penicillins
  • Ampicillin
  • beta-Lactamases